Sunday, September 18, 2011

How Can Computer Viruses Affect Your Medical Practice?

As healthcare becomes increasingly dependent on information technology, system breakdowns due to viruses, worms and other malware can potentially stall the entire working of your practice. This article aims to discuss how practitioners can protect their computers against viruses to ensure the safety and confidentiality of their data systems.

What are Computer Viruses?

A virus is simply a software program or a piece of code that is developed to spread and break into computer systems to consume available memory, corrupt or erase data and eventually cause the system to stop working. 

There are many types of malware and computer viruses and they vary in characteristics, disguises and potency to breach security and spread across networks. 

Computer viruses are nowadays commonly spread by attachments in emails or IM messages. They can also be disguised as attractive images, lucrative discount deals, lottery announcements and other audio-visual files that are likely to arouse user-curiosity and consequent click or download response. Computer viruses and malware are easily spread using free Internet downloads and pirated or illegal programs and files. 

A computer virus infection can be detected from typical symptoms like lowered system speed, frequent hanging or freezing, unprecedented restarts, improper or sluggish functioning of applications, inaccessibility of disk or drives, unusual error messages, missing programs etc.
Even though these indicators may hint at other hardware or software problems, the safest option in such a situation is to run an anti-virus check and contact your data security provider.

How Can Computer Viruses Affect Your Practice?

EMRs and other electronic healthcare data systems hold confidential patient information and practitioners are responsible for their privacy, safety and security. Data theft, loss and system breakdowns due to virus attacks can be very detrimental to a practice and can even put people’s lives in danger.

While effective backup systems and regularly updated anti-virus software can help you avert these debacles, medical professionals must be informed about the repercussions and penalties that HIPAA mandates in case they fail to protect medical information. The federal law treats medical data security as a legal requirement and any compromise on this front is a punishable offense. HIPAA has also released guidelines to assist practitioners and data security professionals in building unbreachable data systems that protect electronic medical data in EMR and other software.

What Can You Do To Prevent Virus Attacks?

A comprehensive data security plan involves regularly updated system security, frequent data backups, employee education and effective administrative policies that regulate the use and accessibility of medical IT systems.

Antivirus Software

When implementing your EMR, ensure that your server and workstations are adequately protected against malware. There are many effective virus protection software programs that help shield your system from viruses, malware and spyware. Ideally, these virus protection programs must be installed and regularly updated as soon as you get your IT infrastructure in place, with or without the EMR. Some antivirus programs are freely available for download online (with paid premium versions) while others can be purchased for a fee. 

We list some of the most effective virus protection software programs that are popular for medical IT security.






In the free to download segment, the most popular antivirus software programs are,

1. AVG


You may also ask your local computer vendor or EMR provider to guide you on the most appropriate protection program for your practice. Many reputable EMR vendors include antivirus and security programs in their services at no additional fee or cost of resources.

Data Backup Systems

Regular backups are an absolute must in order to prevent the loss of crucial medical information to disruptive computer viruses. All data must be backed up on remote servers that are professionally managed by data security experts. With a backup system in place, even if your local server were to get infected and your data were to get erased or corrupted, you would still have all your information secure and intact on this remote server.

Along with antivirus and data backup systems, practitioners and healthcare staff must adopt the following practices in order to build the practice’s defense against unprecedented virus attacks. 
1. Routers and wireless internet connections must be protected with strong, unbreachable password keys.
2. Install firewalls and always keep them on.
3. Do not download attachments or click links from unknown email messages, IMs and social media sites unless you are expecting them. 
4. Do not respond to unusual virus attack warnings from unrecognized sources or download rogue programs that offer to heal the virus. More often than not, they are viruses disguised a antivirus software. 
5. Do not be lured into downloading malware hidden in funny images and unknown audio/video files. Only download from trusted sources and websites.
6. Regularly install updates for all your software. Subscribe to automatic updates if available. 
7. Passwords should be strong and kept confidential. They should ideally include a combination of letters, numbers and symbols and be at least 14 characters long. Staff should be advised to memorize them instead of noting them down somewhere. Also, each application should have a unique password that is not repeated elsewhere in another application, website or program. 
8. Be cautious while using flash drives. Ensure that they are virus-free before running them on your system.


Difference Between Medical Billing Software and EMR

Medical billing and EMR software systems are often designed to have overlapping features that improve the functionality and usability of the systems in order to make them a “one-stop-solution” for a practice’s medical IT needs. As a result, medical billing software and EMRs end up being interchangeably used discounting the primary objectives of each of the systems.

Medical Billing Software vs. EMR

Many EMR companies are going the whole way to provide doctors with a single, comprehensive solution that will help them achieve Meaningful Use by incorporating crucial features like clinical notes, patient information and history, medication/prescription/drug allergies, diagnosis/treatments/procedures, patient scheduling, appointment reminders, e-prescribing, electronically available results, scans and reports, patient education resources, clinical decision support as well as full-fledged medical billing programs.

Specialized medical billing software on the other hand, is particularly programmed to maintain and keep detailed records of tests, procedures, examinations, diagnoses and treatments conducted on patients. It combines this medical information with the patient’s policy details to formulate a complete medical record that is used to generate bills. 

The software electronically submits these bills to the patient as well as the health insurance company for payment. Before a bill can be submitted to the policy provider, it has to be coded based on Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9/ICD-10) protocols. Medical billing software systems are programmed to automatically assign these codes based on the patient’s medical record. After reviewing the bill, the insurance company sends the appropriate payment (or notice of denial) notifying the patient and practitioner via an Explanation of Benefits (EOB) letter which is added to the patient’s medical billing record by the software. In case of a dispute, rectification of bills with errors or missing information and follow up on claims, the software will update the patient’s medical record and billing details with the revised information. 

Medical billing and coding software is thus equipped to seamlessly and accurately handle all complex processes and correspondence involved in medical billing.

A typical base package of medical billing software would contain features that are restricted to medical billing and accounting functions like patient recordkeeping, claims processing, electronic claims submission, receivables management, patient billing and accounting integration. However, many software providers extend their scope to include features like practice management, scheduling and other administrative and clinical functions that are generally a part of EMR software systems.

Therefore, the difference between medical billing software and an EMR is that of core functionality. While medical billing software focuses on a practice’s medical billing procedures and billing-related administrative and financial processes, features of an EMR are primarily concentrated on clinical functions, records and outcomes

Medical billing software may serve clinical EMR functions in addition to electronic billing and coding for greater versatility. The same is true for EMR systems that incorporate specialized medical billing and coding program features to supplement their clinical applications.


Saturday, September 17, 2011

Cloud Computing in Healthcare

This article aims to discuss aspects of cloud computing that are relevant to the healthcare industry and can be applied by doctors to improve their practice.

What Should Doctors Know About Cloud Computing?

There is a sea of information available on the internet about cloud computing and how it works. As a doctor with limited interest in information technology, understanding all that jargon (most of which may not even be directly related to your work and computing requirements) can be quite intimidating and time consuming.

Simply put, the cloud is a set of hardware, networks, storage, services and interfaces that are equipped to provide computing power, infrastructure, applications, software, business processes and storage – in short, all your computing needs, as a service wherever and whenever you need it.

Migrating to the cloud 'can' help you reduce cost, space, time and power that would otherwise be utilized for traditional IT services performing the same functions. This is possible because the cloud puts together a large pool of computing resources available to be used as an assured service by anyone who wishes to use it, anywhere in the world. Traditional IT environments on the other hand, have a limited set of resources that are independently managed and delivered to a limited number of people confined to a certain geographic location, thus pushing cost, time, space and power factors.

Using Cloud Computing To Improve Your Practice

Cloud computing can transform the way healthcare is practiced by empowering professionals to deliver better care at lower costs. Cloud computing allows doctors, researchers and scientists across the globe to collaborate and form a centralized, integrated and regularly updated medical database that can be seamlessly accessed by healthcare professionals without having to invest in over-the-top infrastructure or software. Doctors can use the cloud for viewing reports, scans, EMRs, prescriptions and information required to solve complex medical problems anywhere in the world.

Patients’ health data and EMRs can be combined to form a single, comprehensive health record that can be instantly accessed from one single source. The cloud also brings together patient information like insurance claims, prescription and drug details, lab reports, patient history and progress in cases of chronic illnesses and other details and consolidates them to be available at the point of care whenever required.

This not only helps improve the level of accuracy with which care is delivered but also reduces the time and cost of treatment for physicians and patients alike. As all data is sourced from a single, homogenous center, it also brings down the possibility of conflicting treatments, prescriptions and medical data miscommunication in cases where multiple physicians and providers are involved.

Cloud computing is typically subscription based. In many cases, it works on a metered billing model of payment where you pay only for what you use. It also allows for flexible self-service by which you can enable and disable the provision of required services depending on your usage and needs.

Cloud computing users need not invest in heavy capital expenditure on hardware, software, and services. As resources can be unsubscribed whenever required, the risk of investment is considerably reduced. The cloud also addresses increased data storage needs of physicians without having them spend on expensive personal storage devices. Software updates and innovation are centrally managed by cloud service providers, helping doctors focus the best part of their day on patient care.

Cloud computing can thus help physicians meet meaningful use criteria as it demonstrates better quality of care, lower costs and higher insurance/government reimbursements.

Popular Cloud Services

Most of us have “been on the cloud” without even knowing about it (eg: Facebook is an example of a public cloud). Depending on the visibility of data there are three types of cloud platforms: Public, private and hybrid (a combination of public and private).

A more popular classification is based on the services offered:

1. Infrastructure as a service (IaaS) offers hardware related services like disk storage, database or virtual servers. Amazon Web Services (AWS),Rackspace Cloud Servers and Flexiscale are popular IaaS providers.

2. Platform as a Service (PaaS) offers development platforms. Google’s Application Engine, Microsofts Azure,’s are well-knows in this category.

3. Software as service (SaaS) involves software services on the cloud like web based software applications, email services and so on. Popular examples of SaaS services are (CRM), Google’s Gmail, Google Apps, Dropbox, Zoho, QuickBooks, Piwik, Microsoft Hotmail and their online version of office called BPOS (Business Productivity Online Standard Suite).

A good read on top cloud platforms at

Cloud Security

Cloud security and data ownership is a major concern for users and new adopters of cloud computing. As there is very little regulation currently pertaining to cloud computing, there are many data privacy and security issues to be dealt with. New users must be informed about details on who owns the data, third parties that may gain access to the data and the jurisdiction of the contract. We will look at Cloud Security in detail via a separate article.


Tuesday, September 13, 2011

How Does Email Help You As A Doctor?

Email or electronic mailing has revolutionized business communication. The incentivization of technology in the healthcare industry coupled with its growing inclination towards consumerism and strong patient-doctor relationships has made it necessary for doctors and healthcare professionals to utilize this channel of communication to improve the quality and reach of their practice. However, even though a majority of doctors do own personal email accounts, not many are comfortable using the email for regular, professional correspondence.

Why Should Doctors Use Email?

Doctors are busy people. Email is fast, easy to manage and allows for instant response. As emails can be read on PCs, tablets, smartphones and practically any device with web access in your clinic, home or while commuting, incorporating email communication in your daily practice will help you stay connected with patients and other healthcare professionals wherever you are. 

Email not only improves your accessibility (especially in situations where instant responses are needed for critical correspondence) but also helps you shorten your workday by eliminating those piled up stacks of paper mail that welcome you to your clinic every morning! 
Managing your email is very easy and most free email services are built on simple, user-friendly models. You can send, receive and store all your correspondence instantly, without having to use paper, fax machines or courier services. You can prioritize your mails and respond to them based on the immediacy required. You can use the email to schedule visits, send appointment reminders, prescription refills, lab reports, scans, pre and post surgery care instructions, medication advice and billing details to patients. You can network with media, other doctors and medical professionals in the industry. You can also use it to educate patients by sending useful links and important online study material that could help them understand and work on their condition better.

One of the biggest advantages of using the email is quick and organized storage of all your communication which may include records and other documentation. Your files, scanned paper work, pictures, reports, graphs, numbers and other medical data which have been sent or received via email can be saved and stored online. These files can be neatly organized under appropriate tags for quick and easy retrieval whenever you wish to view them. Adding to that, convenient email search options save you hours of otherwise looking through paper files to find that one elusive paper that just won’t show up!

Using the email to communicate with your patients has a number of advantages. However, you cannot aim to completely replace telephone calls, personal visits and other forms of patient communication with it. One cannot communicate critical medical data requiring the doctor’s personal presence and support using this rather impersonal communication device. Doctors must identify the correspondence that will show positively on productivity and patient satisfaction if exchanged over email and only model those functions and areas under its purview on a regular basis.

Popular Email Services

There are many popular free email services that will help you send, receive, store and manage your correspondence. Gmail, Yahoo, Windows Live and AOL are widely used web email services. MS Outlook or Zimbra can be used to configure your email on your computer and is also a popular choice. Another email service that specifically complies with HIPAA rules is MD (Medical Email). It is a medical industry secure HIPAA email for medical professionals and has over 395,000 doctor-users spanning over 65 medical specialties.

How To Set Up An Email Account?

To set up an email account, key in the URL address of the provider of your choice, click on the usually prominent “Sign up” button, fill a form and you’re ready to get started.
For example, if you wish to set up an account with Gmail, 

2. Click on “Create an account”
3. Fill in the registration form. 
Here is a video which shows you how.

What’s Keeping the Doctors Away?

The medical industry is historically known to be a conservative one characterized by sluggish and rather cynical adoption of technology. Studies indicate that while 90% patients would like their doctors to be accessible over email, doctors continue to elude this space.
One reason for doctors shying away from using the email could be that email correspondence is not reimbursed by insurance providers. Also, most doctors still prefer to operate under traditional models of communication simply because they have been using them for all these years and are too comfortable to venture out and try newer, faster and more productive ways of reaching out to their patients. 
Security and compliance issues are also responsible for doctors being weary about using email communication in their practice. Medical data is always sensitive and like any other form of communication, email too has its medical-legal implications. The AMA lays down guidelines for doctor-patient electronic communication that can be read at
Along with following these guidelines, doctors must ensure that they operate on a secure and reliable internet connection. Computers must be well-protected against spam, virus and other bugs. As a rule of thumb, unknown emails should not be opened. Your password must be unbreachable, kept confidential and regularly changed. Keeping these security guidelines in mind, doctors can safely utilize the benefits of email to improve the productivity and accessibility of their practice.


Thursday, September 8, 2011

How Technology Can Improve The Work Life Balance For A Physician

Doctors and healthcare professionals are not strangers to poor work life balance. A very strong culture surrounds this industry that perceives a doctor wishing to lead a healthy personal life as a sign of weakness. 

It is not uncommon to see doctors resign to the demands of the job and the medical culture system, leading to unhealthy suppression of their personal goals and requirements. No doubt that for some medical professionals, the passion for work overrides the stress and the burning out, but for others, constantly trying to cope with the unwritten but powerful psychological contract of “if you cannot work 18 hours a day and seven days a week, you don’t belong here” can be very overwhelming.

It’s usually only a matter of time until physicians begin to deal with ill health, depression, reduced efficiency and quality of work, lack of focus, fatigue-related medical errors, struggling personal and professional relationships and severe job dissatisfaction to the extent that many end up reconsidering their decision of being in the medical profession submitting to “maybe I’m not wired for this!”

Yes, there are caps on the number of duty hours for doctors. However, the increasing influence of consumerism on the national healthcare system and the growing demands of federal policies call in for greater accountability, increased bureaucracy and a ton of paperwork and administrative chores left to be performed by physicians themselves. This corporatization of work structure compels them to digress from their primary job of providing healthcare to completing clerical and managerial work that now ends up taking the best of their time and productivity, defeating the very idea of Meaningful Work.

In such a situation and keeping in mind the perfectionists that doctors are, one way for them to strike a healthy work life balance without compromising on their productivity or performance would be to focus the best part of their energy and work day on their actual job – that of being good clinicians and reduce the amount of time, effort and personal attention they put into peripherals like paperwork, clinic management and other administrative functions. 

This article aims to suggest help on how physicians may save time on these subordinate activities by using technological tools that will enable them to complete the same tasks quickly and efficiently, leaving them more personal time and a better organized work day.

7 Must-Use Technological Tools for Physicians

1.) Email
Physicians must leverage the power of this simple tool to reach out and connect to their patients without having to extend their workday. Communicating via email can be less intrusive and time consuming as opposed to personal telephone calls as it allows for multitasking, automation, bulk mailing and standardization of regularly used content.

Appointment reminders, medication alarms, direction maps and instructions can be sent out to patients through an automated, pre-programmed system that monitors all your email communication.

2.) Medical Website

In a world where people turn to the Internet for nearly everything, having a web presence not only helps you reach out to a global audience but is also a time saver for functions like briefing new patients about your practice, answering FAQs, providing critical information, clinic details, directions and patient support. For physicians looking to set up a website, a good place to begin would be

3.) Spreadsheet programs like Microsoft Excel

If you haven’t already discovered the treasures of Ms Excel and still go the old pen and paper way to record your administrative activities, insurance, tax, bank and financial details, stocks, inventories and everything that makes up your practice, you are missing out on a tool that can transform your work day and save you a ton of time and trouble. Ms Excel is simple to learn, easy to use and will spoil you for convenience once you’re in the habit of using it. For free online training in Ms Excel, visit

4.) PDAs and Smartphones 

A personal digital or data assistant (PDA) can be used to save all your information paperlessly, in one single place. This information is portable and can be made available on your laptop, phone and other devices. PDAs can be used to store patient contacts, records, medical and other information, drug databases, crucial spontaneous notes, treatment information etc. E-books, medical databases, research and information can also be stored and accessed. You can use them to schedule your day, post reminders for important tasks and have all the information you need in the palm of your hand whenever you need it.

5.) Medical Software such as an Electronic Medical Record(EMR)

EMRs collect and consolidate all patient information into a single integrated system that can be accessed at the click of a mouse. Without having to look through heaps of paper files, EMRs allow for quick and convenient access to the patient's medical history, list of medications, drug allergies, test results and information, helping physicians make faster, accurate and more informed medical decisions, diagnoses and treatments. They also enable instant and simultaneous EMR sharing with other care providers, saving on a whole lot of time that would otherwise be spent in viewing, reviewing and communicating results with other practitioners.

6.) Smartphones/Tablet PCs 

Smartphones are poised to be the next big thing in Healthcare IT. The power of portable information and being connected on the go is sure to lend physicians greater autonomy and flexibility of work schedules. Smartphones and tablets can be synchronized with your office and home computers, PDAs etc and can be used to access this and other medical information from any place in the world. You can effectively use them to do your day’s reading or wrap up pending documentation and record work while commuting or even at home. A good article on using smartphones to improve your practice can be read at

7.) Videoconferencing and Tele-consultations

Physicians can use videoconferencing tools like Skype to provide tele-consultations to patients based in remote locations. They can also carry out pre-appointment screenings, post-appointment follow ups and monitoring from home, saving themselves and their patients commuting time and making for a shorter work day. To learn more about videoconferencing and Skype, visit

These technological tools can be used to reduce the time and effort spent on administrative functions (and certain clinical functions too!). If a routine break up of your day is say 70% of seeing patients and 30% of filing paperwork and records, you can use these tools to work on bringing down the 30% average or even taking it home (easier for solo practitioners) as all the information is digitally available to you, wherever (and whenever) you choose to use it. 

Yes, taking work home is a debatable idea for many families but for physicians, it is really a case of being home at a good hour at least physically vs not being there at all. The trick here is to not get into a habit of “staying connected” all the time, using technology to only accomplish what is required for the day and switch off once you’re done.


Thursday, September 1, 2011

Using Skype To Help Your Practice

What is Skype?

Skype is a software program that allows its users to make voice and video calls between computers (including tablets, smartphones with web access) and voice calls from computers to regular telephones that are not connected to the internet, anywhere in the world. Some of their services are free to use while some are available for a fee. 

What makes Skype such a valuable asset to medical practice is its videoconferencing tool. Gaining widespread adoption in the healthcare industry, this tool has the potential to transform the process and practice of medicine for physicians as well as patients.

Skype in Healthcare
 Practitioners have identified a number of functional areas where Skype can help improve the quality of care by raising the level of accessibility, reach and convenience for both patients and doctors.

While Skype calls and videoconferencing may not serve to replace personal visits and interactions, many physicians are turning to it for pre-appointment screening and post-appointment follow-ups and monitoring. Some doctors use Skype to effectively educate new patients prior to their first consultation to get them familiar and comfortable with typically intimidating medical environments. In remote areas with inadequate medical care facilities, Skype video calling allows patients to connect with their doctors and other medical providers for virtual consultations and evaluations, saving on a good amount of travel and other medical expenses. 

Skype is also gaining popularity in helping patients keep in touch with their loved ones in medical facilities like children’s hospitals (Skype works with UCSF Children’s Hospital and UCSF Medical Center), birthing suites and skilled nursing units.

One subspecialty that has greatly benefited from Skype’s video communication is Psychiatry. As America’s baby boomers age (over 50% of the 85+ age group deals with dementia), healthcare costs are positioned to rise. In such a situation, Skype offers an affordable and effective alternative for patients to interact with their doctors and be regularly monitored without having to spend time and money on travelling and office visits. It also enables doctors to access higher healthcare education via Skype-enabled virtual classrooms taught by global healthcare experts.

As Skype strengthens its focus on mobile users, medical professionals are presented with newer opportunities to leverage this trend for improving their practice as well as the relationship they share with their patients.

Getting Skype for your Practice
To make a Skype call, you will need the following:
- Desktop/Laptop/Tablet/Smartphone/Skype-enabled TV
- Internet access
- A microphone and headset
- Optional Web camera (even though most laptops have a built-in web cam, it is advisable that patients purchase a separate, detachable web cam that can be adjusted to focus on specific body parts that need virtual examination)
- Optional Skype Accessories like USB Phones, Bluetooth Headsets, Skype VoIP Adapters can also be used to enhance your Skype experience

Once, you have all the hardware and equipment in place, the next step is to download the program from their website. You can do so here:

After downloading Skype (ensure that you download the version that’s compatible with your particular device), you have to install it on your system. 

Both these steps are as easy as signing up for an email and are very well explained on their website. 

When you have finished the download and installation, you will log in with your Skype name and Password from your system.

On logging in, you will be able to add your patients to your list of Skype contacts (in case they have added you already, you may accept their request). You can make or receive voice and video calls to/from anyone in your contact list. 

If you still have doubts concerning the download and installation, this Slide Share presentation offers a simple Step-by-Step guide through the entire process.

Video Calling On Skype

You can use Skype to offer high quality virtual consultations, pre-appointment screenings, follow-ups and monitoring to your patients. However, for a clear, uninterrupted video call, you will need a fast internet connection, or in the case of smartphones, a mobile data plan or Wi-Fi. 

Watch this online tutorial to know exactly how you can make video calls using Skype:

Skype Features For Your Practice

- Platforms Supported by Skype
Skype is available on Windows, Mac, Linux, Android, iPhone, Symbian platforms. You can also make high quality video calls from Skype-enabled Panasonic, Samsung and Sony TVs as well as Blu-ray™ players from Panasonic and Sony.

- Free to Use Skype Services
Skype offers a number of services that you can use free of charge to connect with patients and other medical providers across the globe. Skype-to-Skype calls, One-to-one video calls, instant messaging and screen sharing are features that you can use for free. For practitioners using Skype for the first time, these features will more than serve your purpose, at least to begin with. Once you get comfortable using the software and are able to identify the features that will fulfill your specific communication needs, you can always upgrade to the paid and premium versions.

- Paid Features
Skype’s paid features include voice calls to regular phones and cell phones anywhere in the world at very low calling rates, SMS, call forwarding, voicemail, group video calling with three or more people in a single video call and live chat support. You can also get your own online Skype number for your patients to call and reach you wherever you are or you can sign up for a Skype To Go number to make low-cost international calls from your mobile or regular landline. These features are competitively priced, depending on the subscription package you opt for.

Skype Security for Healthcare – HIPAA Compliance

Despite Skype’s potential to combat rising healthcare costs, busy patient and physician schedules and healthcare accessibility issues, practitioners seem to be reluctant to adopt Skype in their practice due to the controversy surrounding its security and compliance protocols. 
However, Skype’s 256-bit-point-to-point encryption is in agreement with HIPAA’s privacy requirements. It is a secure videophone and any HIPAA requirements that apply to a regular telephone are applicable to Skype. Practitioners, however, must ensure that their systems are well-protected against spammers, bugs and malware as a precautionary and safety measure that holds not just for Skype but for any other web-related activity as well.